book reviews, depression, psychology

Response from Dr. Yahnke

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In the previous post regarding the book, Sophie’s Choice, I referenced a fine paper by Dr. Beverly Yahnke. A couple of people raised questions about whether she was advocating the breaking of the confessional seal in the second to last paragraph of her paper. I took the liberty of contacting her directly about this, and this was her response:

DarkMyRoad invited me to review the most recent postings regarding my paper,”The Taxonomy of Despair” and I appreciate the opportunity to respond to the very appropriate concern raised regarding confessional privacy.

As one who treaures the practice of individual confession and absolution, I prize the confidentiality of the confessional and would never recommend that any pastor violate the privacy promised the penitent.

For the record, the Saint Louis speech was addressed to parish nurses, church workers of all stripes, family, friends and pastors of the despairing. Every single one of those individuals should seek external professional assistance to respond to a person who is acutely suicidal UNLESS that information is offered as part of individual confession and absolution. In that case, the pastor is always bound to protect the privacy of the penitent. (I presumed that point to be obvious to the pastors in attendance; hence did not feel the need to dwell on the matter.) I should underscore that most of the time, as the paper suggests, individuals in end stage self-loathing and seeking escape are not seeking an opportunity for conversation or confession. They are barely tolerating any care of any sort. In fact, the most frequent conversation about end stage despairing individuals often takes the form of a pastor who learns from a friend or a family member that a soul is dangerously pre-occupied with suicidal thoughts or self-loathing. If the soul refuses care and remains at risk, I believe that the pastor must act to provide appropriate safety in seeking care for the mentally ill — whenever the seal of the confessional does not prohibit it.

Dr. Bev Yahnke

There you have it. Does that make sense?

-DMR

book reviews, depression, Pastoral Office

Sophie's Choice

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I recently finished reading an intriguing book by William Styron entitled Sophie’s Choice. Styron is the same author who wrote Darkness Visible, which I have commented on before. As a disclaimer, I will say that there is LOTS of poor language, sex, and other generally in appropriate things in the book, and that as a Christian reading it, you need to be prepared.

Having said that, it really is an amazing book.

Sophie, a Polish refugee who survived Auschwitz/Birkenau, is haunted by the terrible things she did in Cracow and again at the concentration camp. She went face to face with a great evil, and in her mind, she failed. Depression doesn’t even begin to describe her mental state. She is suicidal clearly, and is in the midst of a bizarre abusive relationship that the reader doesn’t truly understand until near the end of the book. Her boyfriend is schizophrenic, and so goes through periods of extreme violence and periods of “normalcy” along the way. In the end, she and her boyfriend complete a suicide pact which they had aborted some months earlier.

[spoiler: don’t read this paragraph if you want to read the book and be in suspense.]
The choice which she had to make was which one of her children would get to live, and which would get to die. She is forced to make this choice because she was Polish; for the Jews at the time, all the children died. But she got to choose one to live. The ultimate evil, or pretty darn close.

Now a number of things about this book have gotten me to continue thinking about it. First, the obvious traumatic event which triggers as deep and dark a depression as one can imagine. There was no history of depression in her family. Of course, I expect that seeing those kind of horrors will change a person no matter what. But to be asked to choose which child lives, and which dies. That would be the ultimate breaker of a personality, I would say.

The second is her obvious desire for redemption and forgiveness, even though she has abandoned her Catholic upbringing, because God “abandoned” her. Here is a perfect example of where do you go to look. She tried them all. Music, alcohol, sex, living the wild side, the whole gambit. She went everywhere except to the One who could help. The narrator (Stingo) is also an agnostic, and so the thought never really occurs to him.

Finally, we can see in Sophie’s Choice the devastating effect that events and how they are interpreted in our lives can have on us. There is no happy ending or making good with choosing between two of your children, only to have both of them die in the end.

For the Christian, how one address people in pain and suffering is a critical understanding. On the one hand, we can’t simply dismiss despair in whatever form it takes as merely unbelief to be squashed. In sin, every sinner is both the participant and the victim. Our task (esp. as pastors) is to minister to them, to draw the sin out, and to provide healing that is real and lasting. A part of that means when it comes to despair that there are real reasons why people fall into despair.

It also means providing them with hope to give hope where it belongs, in Jesus Christ and him crucified. But this doesn’t mean pat answers. It means tackling tough questions, admitting when we have no idea, and weeping with those who weep.

There is a fascinating paper out in cyberworld that addresses this topic by Dr. Bev Yahnke. It’s called Prescriptions for the Soul: The Taxonomy of Despair. Read it. And read this book. I look forward to your thoughts on the matters

-LL

book reviews, depression, Pastoral Office

Sophie's Choice

9 Comments


I recently finished reading an intriguing book by William Styron entitled Sophie’s Choice. Styron is the same author who wrote Darkness Visible, which I have commented on before. As a disclaimer, I will say that there is LOTS of poor language, sex, and other generally in appropriate things in the book, and that as a Christian reading it, you need to be prepared.

Having said that, it really is an amazing book.

Sophie, a Polish refugee who survived Auschwitz/Birkenau, is haunted by the terrible things she did in Cracow and again at the concentration camp. She went face to face with a great evil, and in her mind, she failed. Depression doesn’t even begin to describe her mental state. She is suicidal clearly, and is in the midst of a bizarre abusive relationship that the reader doesn’t truly understand until near the end of the book. Her boyfriend is schizophrenic, and so goes through periods of extreme violence and periods of “normalcy” along the way. In the end, she and her boyfriend complete a suicide pact which they had aborted some months earlier.

[spoiler: don’t read this paragraph if you want to read the book and be in suspense.]
The choice which she had to make was which one of her children would get to live, and which would get to die. She is forced to make this choice because she was Polish; for the Jews at the time, all the children died. But she got to choose one to live. The ultimate evil, or pretty darn close.

Now a number of things about this book have gotten me to continue thinking about it. First, the obvious traumatic event which triggers as deep and dark a depression as one can imagine. There was no history of depression in her family. Of course, I expect that seeing those kind of horrors will change a person no matter what. But to be asked to choose which child lives, and which dies. That would be the ultimate breaker of a personality, I would say.

The second is her obvious desire for redemption and forgiveness, even though she has abandoned her Catholic upbringing, because God “abandoned” her. Here is a perfect example of where do you go to look. She tried them all. Music, alcohol, sex, living the wild side, the whole gambit. She went everywhere except to the One who could help. The narrator (Stingo) is also an agnostic, and so the thought never really occurs to him.

Finally, we can see in Sophie’s Choice the devastating effect that events and how they are interpreted in our lives can have on us. There is no happy ending or making good with choosing between two of your children, only to have both of them die in the end.

For the Christian, how one address people in pain and suffering is a critical understanding. On the one hand, we can’t simply dismiss despair in whatever form it takes as merely unbelief to be squashed. In sin, every sinner is both the participant and the victim. Our task (esp. as pastors) is to minister to them, to draw the sin out, and to provide healing that is real and lasting. A part of that means when it comes to despair that there are real reasons why people fall into despair.

It also means providing them with hope to give hope where it belongs, in Jesus Christ and him crucified. But this doesn’t mean pat answers. It means tackling tough questions, admitting when we have no idea, and weeping with those who weep.

There is a fascinating paper out in cyberworld that addresses this topic by Dr. Bev Yahnke. It’s called Prescriptions for the Soul: The Taxonomy of Despair. Read it. And read this book. I look forward to your thoughts on the matters

-LL

depression, stimulation, stress

Globalizing

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I am having a bad week. Not a “I’m gonna die so just shoot me now” bad week. Just a bad week. Some things have happened that I don’t like, and while at one level I’ve “handled” them pretty well, made good decisions involving my own health, etc., it has not changed the fact that the fog has rolled in much more than I would like. I feel like I’m in slow moving quicksand, and I’m afraid of a relapse. I don’t want to go back to where I was even a month ago. I want to move forward, but I’m afraid.

This is what we might call Globalizing: taking an isolated event or time period, and extrapolating a whole series of future events that all work off the worst possible construction theory. Now everyone is susceptible to this. Everyone has their moments of despair and when you can’t see the future.

For one suffering from depression, globalizing is, well, more like solarsystemizing.

Instead of thinking of the stead progress that (by God’s grace) I have made over the last six months, I simply catapult back to the worst, the foggiest moments of my illness. It’s absurd. It goes against all of God’s promises for health and healing. It discounts medication, therapy, a supportive family, supportive pastor, and everything else good that has happened to me in the last year.

Yet it is how I feel. It is what I dread. My mind and body tell me that I am going to fall all the way back a year or more.

Is it true?

NO. It’s not true. I’m having some bad days. That’s all it is.

So what do you do when you’re slumping? You do what you know has helped you in the past. Here are a few of mine, but I’m sure you have your own list.

  • Get outside.
  • Golf
  • Work in the shop
  • Play chess or some other game (cards) that engages your brain elsewhere.
  • Spend quality time with your spouse.
  • Have some quiet, but don’t isolate yourself.
  • Pray

Those are a few. God’s peace be with you.

-DMR

book reviews

Devotions and Book(s)

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I am really doing a lot of writing right now. Tragically it’s not here. But this is another way you can help the cause.

One of the things I have completely missed is any kind of theological treatise on suffering that would help the Christian understand how suffering fits into the Christian life. I know there’s a bazillion things out there. What’s the best?

In connection with this, what are the best books/articles any of you have read on depression? What are the worst?

Have any of you run across any devotional booklets that were actually helpful? (I’m thinking about another project here.)

Thanks for any input you can give

anfechtung

Torn between….

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Sorry I’m not posting quite as much as usual right now. I am in the midst of trying to write a draft of this book I posted about earlier. It’s good, and I’m very excited about (insofar as someone on as many drugs as I am can be excited), so it’s taking more of my time. But have no fear. I haven’t left, and I’m not going anywhere.

-DMR

depression, therapy

Venting on the WSJ on Depression

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HERE is an article by a WSJ columnist in their Opinion Journal section about depression in America. It really ticked me off.

It ticks me off because the author says this at the end of the article:

I suspect, however, that cultural differences can account for only so much. Economics must also be at work. Consider Jean-Baptiste Say’s famous insight that supply creates its own demand. We know this to be true about, for instance, personal computers: There was never any demand for PCs until Steve Jobs put one on the market and persuaded consumers it was something they should have. Just so with depression: Is there a country on earth where Prozac is more widely prescribed, or therapy more readily available, than the U.S.? It should hardly be surprising, therefore, that Americans now find themselves so depressed.

None of this is to say that depression is not, for those who suffer acutely from it, a serious matter or that it doesn’t warrant attention and care. But it is also true that what we now call “depression” is something previous generations also knew, albeit with different names: melancholy, unhappiness, “the blues.” In song, in church, in labor, in philosophy and in the bonds of family, community and tradition they were often able to find genuine consolations.

Such consolations still exist, though we no longer think of them as cures. Given how badly our own “cures” seem to be working, perhaps it would be well if we did.

Well, here’s the problem. There is nothing magical about the word “depression”. It is used colloquially for probably a dozen different diseases, maybe more. Some of those diseases are more common in different places. But generally speaking, any kind of illness of the mind can fall under the category of depression.

Furthermore, it is not simply a matter of consolation or of being happy. What a silly thing to say. The goal of life is not to be happy at the end of the day. Our goal as Christians is to be in communion with Christ, and to find our rest in Him. Even most other religions or secularists will recognize that “happiness” is not everything. I’m all for happiness, but please. Is that a medical diagnosis?

The same may be true for the word consolation. It evokes images of patting someone on the back when they’ve had a bad day, or simply sitting down and listening to a friend. Again, I’m all in favor of consolation. Consolation may be found in many different places, some of which the author listed. Consolation (I would suggest) is a portion of the healing which must come about in order to recover from depression. But it is not the “cure”.

Mr. Stephens, your article cited a lot of statistics, and pulled the public conversation about depression backwards, not forwards. I hope that you never have to suffer as we have suffered, but if you do, you will find your own words as painful as I do.

-DMR

PS Yes, I’m in a crabby mood today.

book reviews, depression, pharmacology

The Second Book I've Read: Prozac Nation

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Ten years ago or so, this book, Prozac Nation, was the hot ticket. Written by a young up-and-coming female writer, it was hailed as fresh and innovative, courageous, raw, and a bunch of other nice things. It was a part of a genre of self-disclosure that was (and is) extremely popular. But written just a few years after William Styron’s Darkness Visible: A Memoir of Madness, this book was written for the young and the restless. Lots of colorful language, a few titillating references to sex, and sort of a super-extension of teenage angst, the book had everything that other books of the genre lacked. It had a movie made about it. It was a bestseller, and so forth.

When I first read this book, early on into my illness, I found it liberating and deeply moving. It described what I couldn’t. Despite the sometimes whiny voice, it served an important purpose for me in understanding what I was going through. I wasn’t crazy; I had a mental illness.

I’ve read it again, and my views on the book are very different. It does describe the state of depression well. It does describe the roller coaster of medications pretty well also. It was, however, written at a time when Prozac was the first of a panoply of anti-depressants to come on the market. In many respects this is better, as more people have more options for healing. But this phenomenon has also added the maddening factor of doctors bouncing you from drug to drug, seeking to find the magic cocktail that will be the right fit. It can be a profounding frustrating and, well, depressing experience.

Back to Prozac Nation. After reading Styron’s book above, and others (which I’ll get to in due time), I find that Wurtzel is not as helpful as other memoir-type books of the genre. One of the dangers of reading memoirs like this while you’re in the midst of the illness is that it can give you ideas, prey upon your already overactive anxieties, and create a mental state which may not have been there at the start. It’s usefulness for those suffering from depression and anxiety comes more as an afterward than as a self-diagnostic tool.

Now what I do find extremely useful in this book is how it chronicles all of the different types of self-medicating that we go through. Alcohol (the pastor’s choice most of the time), uppers and downers of various sorts, over-the-counter drugs, sex, relationships. We can use almost anything as a narcotic against the creeping darkness and the coming fog. They are all attempts to escape from our lives, or to feel SOMETHING so that we can know we are still human. In that respect it is helpful

Completely lacking in the book, though, is any real interaction with the spiritual element of depression and anxiety. Wurtzel is basically a non-practicing Jew, where religion and spirituality of any sort plays no part in her worldview. That is helpful to recognize at the outset, but that also means that the Christian suffering from depression and anxiety is going to find this book completely lacking in one of the key elements of their suffering. It is a picture of the disease, but it is not a complete picture.

If someone were to ask me today what book could I read to describe what I’ve gone through, I’d probably give them Darkness Visible, because it fits my own experience closer than Wurtzel. However, I would also tell them that there isn’t anything out there that I’ve read which really nails it completely, so they’ll have to wait for the book…

-DMR

A Lutheran View of Depression